Abortion in a New Zealand cohort - Incidence, reasons and emotional impact

Burgess, Meredith Anne

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Burgess, M. A. (2018). Abortion in a New Zealand cohort - Incidence, reasons and emotional impact (Thesis, Master of Public Health). University of Otago. Retrieved from http://hdl.handle.net/10523/7910

Background: Abortion is a relatively common experience for New Zealand women. The reasons for abortion have not been studied in a New Zealand context. While the potential links between mental health outcomes have been studied extensively in New Zealand and internationally, the emotional impact of abortion is less often described.

Aim: To describe the incidence, circumstances, reasons and emotional impact of abortion for women and men by age period (under 21 years, 21-26 years, 26-32 years and 32-38 years).

Methods: A longitudinal study of a cohort born in New Zealand between 1972 and 1973. Outcomes measured were the outcome of all pregnancies, self-reported reasons for abortion and the emotional impact of abortion. Related characteristics or circumstances such as, happiness about pregnancy, preconception relationship, attitude to abortion and who made the abortion decision were also described. The epidemiological approach was a descriptive study of the incidence, reasons for and impact of abortion. Associations between various measures were tested using Chi-Squared tests.

Results: For the entire study period (up to the age of 38), the rate of abortions was 349 per 1000 women. One in four women reported abortions and one in five men reported abortions and almost one in six of all pregnancies with known outcomes ended in abortion. The proportion of reported pregnancies that ended in abortion was greatest in the youngest age period and declined as the study members aged. Being not ready was the most common single reason reported for abortion, followed by relationship reasons, including being in the wrong relationship and being alone. Relief predominated as the feeling reported by women following an abortion, and men reported a higher proportion of regret following an abortion than women. There are potential associations between a negative emotional impact and women focused reasons for abortion, such as career, education and health.

Conclusions: Abortions are common outcomes of pregnancies, especially at younger ages. The reasons for abortion that are reported here may provide clarification for policy makers and for clinicians in terms of understanding the perspectives of women that undergo abortions, though further qualitative research is necessary. Associations between reasons for abortion and emotional impact may be clinically relevant in order to identify those who are vulnerable to negative impacts and provide better post-abortion care. Further research to identify who is at risk of long term negative impacts should include both New Zealand women and men.